Classification and clinical manifestation of hemifacial microsomia (with a literature review)
DOI:
https://doi.org/10.57231/j.idmfs.2026.5.2.003Keywords:
Classification and clinical manifestation of hemifacial microsomia (with a literature review)Abstract
Craniofacial microsomia (CFM) is the second most common congenital facial anomaly after cleft lip and palate. Based on a review of the literature, the authors present a chronological overview of the existing and most frequently used classification systems. The development of numerous classifications has primarily been associated with the pronounced polymorphism of clinical manifestations of hemifacial microsomia, as well as their application in surgical treatment planning and outcome assessment. According to the general consensus, the classifications presented above are not fully adequate for selecting optimal treatment strategies or for evaluating treatment outcomes. Analysis of the clinical material demonstrated the highest frequency of presentations with type I involvement - characterized by a hypoplastic temporomandibular joint - observed in 70 patients (60%). The majority of these patients were aged 13 -18 years (36 patients). with type IIa 20 patients -17.2%. With type IIb - 17 (14,6%), type III-9 patients (7.8%), type IV -3 patients (2,6%). For the determination of surgical treatment protocols, the Pruzansky classification, later modified by L. B. Kaban, is considered particularly informative..
References
Каламкаров Х.А. Рабухина Н.А., Безруков В.М. Деформации лицевого черепа. М.: Медицина.1981
Al Zamel G, Odell S, Mupparapu M. Developmental Disorders Affecting Jaws. Dent Clin North Am. 2016; 60:39–90. doi: 10.1016/j.cden.2015.08.002.
Alexander J, Gougoutas , Davinder J Singh, David W Low, Scott P Bartlett Plast Hemifacial Microsomia: Clinical Features And Pictographic Representations Of The OMENS Classification System Reconstr Surg. 2007 Dec;120(7):112e-113e
Allam KA. Hemifacial Microsomia: Clinical Features and Associated Anomalies. J Craniofac Surg. 2021 Jun 1;32(4):1483-1486. doi: 10.1097/SCS.0000000000007408. PMID: 33587521
Converse J M, Coccaro P J, Becker M, Wood-Smith D. On Hemifacial Microsomia. The First And Second Branchial Arch Syndrome. Plast Reconstr Surg. 1973;51: 268–279.
Edgerton M T, Marsh J L. Surgical treatment of hemifacial microsomia. (First and second branchial arch syndrome) Plast Reconstr Surg. 1977;59: 653–666.
F.Ronald Vento M. D, Richard A.Labrie Ed.D. and JohnB.Milliken.M.D. The O.M.E.N.S.classification of Hemifacial microsomia. Online Mendelian Inheritance of Man (OMIM). Hemifacial microsomia: gene map. Available at:h tt p: // ww w.n cb i. n lm . n ih .g ov/ Om im /getmap.cgil164210. Accessed October 7, 2019) Plast Reconstr Surg Glob Open,
Grabb W C. The First And Second Branchial Arch Syndrome. Plast Reconstr Surg. 1965;36: 485–508.
Huisinga-Fischer C. E., Zonneveld F. W., Vaandrager J. M., . Prahl-Andersen B. CT-based size and shape determination of the craniofacial skeleton: a new scoring system to assess bony deformities in hemifacial microsomia. J Craniofac Surg. 2001 Jan;12(1):87-94
Jason D Wink , Jesse A Goldstein, J Thomas Paliga, Jesse A Taylor, Scott P Bartlett.The mandibular deformity in hemifacial microsomia: a reassessment of the Pruzansky and Kaban classification Plast Reconstr Surg. 2014 Feb;133(2):174e-181e.8;56:628–638.
Kaban L B, Padwa B L, Mulliken J B. .Surgical correction of mandibular hypoplasia in hemifacial microsomia: the case for treatment in early childhood. J Oral Maxillofac Surg. 1998may 56(5) ; 628-638
Kawamoto HK, Kim SS, Jarrahy R, James PB. Differential diagnosis of the idiopathic laterally deviated mandible. Plast Reconstr Surg. 2009;124:1599–1609. doi: 10.1097/PRS.0b013e3181babc1f. - DOI - PubMed
Kim BC, Bertin H, Kim HJ, Kang SH, Mercier J, Perrin JP, Corre P, Lee SH. Structural comparison of hemifacial microsomia mandible in different age groups by three-dimensional skeletal unit analysis. J Craniomaxillofac Surg. 2018;46:1875–1882. doi: 10.1016/j.jcms.2018.08.009. - DOI - PubMed
Kruchinskii G V, Classification. B.S. Plastic And Reconstructive Surgery 80(4): P 525-533, October 1987.
Kruchinskii G V. Classification of the syndromes of branchial arches 1 and 2. Acta Chir Plast. 1990;32(3):178-90.
Lauritzen C, Munro I R, Ross R B. Classification and treatment of hemi-facial microsomia. Scand J Plast Reconstr Surg. 1985;19: 33–39.
Longacre JJ, de Stephano GA, Holmstrand KE. The surgical management of first and second branchial arch syndromes.Plast Reconstr Surg 1963;31:507–520
Madrid JR, Monfealegre G, Gomez V. A New Classification Based On The Kaban's Modification For Surgical Management Of Craniofacial Microsomia. Craniomaxillofac Trauma Reconstr. 2010 Mar;3 (1):1-7.
Meazzini MC, Brusati R, Diner P, Giannì E, Lalatta F, Magri AS, Picard A, Sesenna E. The importance of a differential diagnosis between true hemifacial microsomia and pseudo-hemifacial microsomia in the post-surgical long-term prognosis. J Craniomaxillofac Surg. 2011; 39:10–16. doi: 0.1016/j.jcms.2010.03.003.
Meazzini MC, Caprioglio A, Garattini G, Lenatti L, Poggio CE. Hemandibular hypoplasia successfully treated with functional appliances: Is it truly hemifacial microsomia? Cleft Palate-Cran J. 2008; 45:50–56. doi: 10.1597/06-201.1
Munro I R. Treatment of craniofacial microsomia. Clin Plast Surg. 1987;14:177–186 Hemifacial microsomia: a multisystem classification. Plast Reconstr Surg. 1987;80:525–535.
Pirttiniemi P, Peltomaki T, Muller L, Luder HU. Abnormal mandibular growth and the condylar cartilage. Eur J Orthod. 2009; 31:1–11. doi: 10.1093/ejo/cjn117.
Pruzansky S. Not All Dwarfed Mandibles Are Alike. Birth Defects. 1969;5: 120.
Swanson JW, Mitchell BT, Wink JA, Taylor JA, Bartlett SP Surgical Classification of the Mandibular Deformity in Craniofacial Microsomia Using 3-Dimensional Computed Tomography..Plast Reconstr Surg Glob Open. 2016 Feb 5;4(1): e 598
Taiwo AO. Classification and Management of Hemifacial Microsomia: a Literature Review. Ann Ib Postgrad Med. 2020 Jun;18(1):S9-S15. PMID: 33071690; PMCID: PMC7513375.
Tenconi R, Hall B D. Hemifacial microsomias: phenotypic classification, clinical implications and genetic aspects. In: In: Harvold EP, Vargervick K, Chierici G, editor. Treatment of Hemifacial Microsomia. New York: Alan R. Liss; 1983. pp. 39–49.
Tuin AJ, Tahiri Y, Paine KM, Paliga JT, Taylor JA, Bartlett SP. Уточнение взаимосвязей между различными признаками классификации OMENS+ при краниофациальной микросомии. Пластическая реконструкция хирургии, январь 2015; 135(1):149e-156e. doi: 10.1097/PRS.000000000000000843. ПМИД: 25539322.
Vento A R, La Brie R A, Mulliken J B. The O.M.E.N.S. classification of hemifacial microsomia. Cleft Palate Craniofac J. 1991;28: 68–76.
Xiaohui QIU1, Xianxian YANG1, Haisong XU1, Zin-mar AUNG1, Xiaojun CHEN1, Yan ZHANG1, Gang CHA Classification of Hemifacial Microsomia Based on Bone Volume Ratio of the Healthy and Affected Sides of the Mandible: A Retrospective Self-control Experimen. Chinese Journal of Plastic and Reconstructive Surgery March 2020, 2(1):35-50. DOI:10.1016/S2096-6911(21)00006-6
Xue X, Liu Z, Wei H, Wang X. A.. Proposal for the Classification of Temporomandibular Joint Disc Deformity in Hemifacial Microsomia. Bioengineering (Basel). 2023 May 16;10(5):595. doi: 10.3390/bioengineering10050595. PMID: 37237665; PMCID: PMC10215351.
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.